The Central American countries: Guatemala El Salvador Honduras Nicaragua Costa Rica and Panama are in transition from a dietary culture based mainly on maize to a wheat-containing diet. This review documents the presence of celiac disease in Central America. It draws attention to some of the challenges in planning systematic studies in the region since up until recently celiac disease was unknown. The aim of this review is to disseminate knowledge obtained with preliminary data to stimulate clinical and basic scientists to study these diseases in Central America and ZM 306416 hydrochloride to alert authorities responsible for the planning of education and health to find possibilities to avoid a rise in these disorders before the epidemics start as has occurred in the Mediterranean countries. . No data is available in Central America. 4 Results Preliminary studies of celiac disease in Central America: 4.1 Guatemala In Guatemala a master thesis written by a nutritionist  determined the number of patients suffering from celiac disease in private clinics in gastroenterology of the capital city of Mouse monoclonal antibody to Rab4. Guatemala in order to develop a manual of nutritional guidance to the Guatemalan celiac ZM 306416 hydrochloride patient. The results showed one case of celiac disease for every 1000 adult patients. The most frequent age of patients diagnosed was from 31 to 50 years of age 59 were female. The “Asociación de Celíacos de Guatemala (“Celiac Patients’ Association of Guatemala”) was founded in Guatemala city in 2013 by Dr. E. Ligorría who is deeply involved in the study of celiac disease and the treatment of local celiac patients. No data has been published yet. It is to be hoped that he will be ZM 306416 hydrochloride able to organize systematic studies not only among the mestizos (people of mixed Native and European heritage) population but also among the indigenous Mayan descent population of Petén the northernmost department of Guatemala. This population would be important to study the distribution of HLA antigens and the effects of the ongoing dietary transition from maize to gluten-containing products. 4.2 El Salvador The first study using the modified Marsh classification and the full HLA-DQ typing in El Salvador has been recently published . Based on serological tests histological features of duodenal biopsy specimens and the response to a gluten-free diet 32 individuals (23 females and 9 males) were diagnosed with celiac disease. The age at diagnosis ranges from 19 to 77 years. All patients are urban residents. Upon revision of the biopsy specimens and classification of the histological features 28 showed the histological features that are compatible with celiac disease . Twenty-three have celiac disease risk genotype: 14 HLA-DQ8 (DQA1*03/DQB1*0302; 12F and 2M) 7 HLA-DQ2.5 (DQA1*05/DQB1*02; 3F and 4M) 2 HLA-DQ2.5 and DQ8 (1F 1 and 9 cases (7F 2 who had neither DQ2.5 nor DQ8. All nine non-DQ2.5/non-DQ8 cases reported an improvement of symptoms with a gluten-free diet; two had been diagnosed abroad. Seven ZM 306416 hydrochloride out of nine non-DQ2.5/non-DQ8 celiac disease patients were heterozygous carriers of allele DQA1*05 only and one had HLA-DQ2.2 (DQA1*0201/DQB1*02). One patient did not possess an HLA-DQ genotype associated with celiac disease. Another patient had also dermatitis herpetiformis. Ethnic admixture is characteristic of El Salvador. In the ethnic categories identified in colonial times the predominance of mestizos is important in El Salvador. Several factors influenced this outcome: (a) in El Salvador’s current territory there was no place where indigenous peoples could find refuge so that they and the Spaniards had to coexist in the same space; (b) the decrease in the indigenous population due to diseases and massacres; (c) population break up due to its exploitation for the cultivation of indigo in the 18th and 19th centuries. In El Salvador the “Asociación de Celíacos y Sensibles al Gluten de El Salvador” (ACELYSES) (“Celiac and Gluten Sensitive Association in El Salvador”) is playing a predominant role in dissemination of knowledge. The primary mission is the dissemination of information on gluten-related disorders as well as promoting education and awareness among celiac disease and gluten-sensitive people their families public and private health institutions and other organizations which have an impact on the quality of life of celiac and gluten-sensitive people in El Salvador. 4.3 Honduras Only isolated cases of celiac disease have been reported in Honduras. There is no celiac or gluten sensitive patient.